Seborrheic Dermatitis
A scaly, erythematous eruption affecting the central part of the face, eyebrows, eyelids, nasolabial folds, postauricular and beard areas, scalp, and body flexures. The central chest and interscapular areas can also be affected. Seborrheic dermatitis affecting the eyelids causes blepharitis and sometimes associated conjunctivitis. Despite its name, seborrheic dermatitis appears to have nothing to do with sebum.
Treatment: Seborrheic dermatitis of the scalp can be effectively treated with various shampoos. Active ingredients include sulfur, zinc pyri-thione, salicylic acid and sulfur, and tar. The scalp should be shampooed frequently, daily if necessary, and the product left in contact with the scalp for the recommended interval, usually 5 min. If shampooing is inconvenient or physically impossible, the patient can use topical corticosteroid lotions instead. Applied to the scalp bid, such lotions are helpful in severe cases. Hydrocortisone 1% lotion is often sufficient, but many fluorinated corticosteroid preparations are available as well.
Seborrheic dermatitis of the face and trunk is usually effectively treated with hydrocortisone 1% cream applied bid or tid. Preparations containing sulfur or salicylic acid are also helpful.
Seborrheic blepharitis can be treated with hydrocortisone 1% cream. If associated conjunctivitis requires intraocular administration of a corticosteroid ointment or suspension, an ophthalmologist may need to monitor intraocular pressure.
Irritant Contact Dermatitis
The most common form of contact dermatitis, this condition results from skin contact with strong chemicals or other irritants. Although the elderly have a less pronounced inflammatory response to most irritants than do younger patients, chronic irritant dermatitis occurs frequently in the elderly. The reason may be that their slower, muted cutaneous reactions make the contactant less obvious, so exposure continues.